Testicular Cancer

Testicular cancer is a cancer that begins in one or both testicles, the organs that make sperm and testosterone. It most often develops from germ cells, which are the cells that produce sperm. Although it can affect people of different ages, it is most common in younger and middle-aged men. Finding a testicular change early allows prompt evaluation and treatment.

The main germ cell tumor categories are seminoma and nonseminoma. Seminomas often grow more slowly, while nonseminomas include several tumor types and may behave more aggressively. Less common testicular cancers can begin in supporting cells, and some cancers from elsewhere in the body can spread to the testicle.

Testicular cancer may cause a painless change in a testicle, but pain or discomfort can also occur. These symptoms may have many causes, so symptoms alone cannot confirm or rule out cancer. A new, persistent, or unusual change should be assessed by a healthcare professional.

Testicular cancer starts when cells acquire genetic changes that allow them to grow and divide without normal control. The changes most often occur in germ cells, which can develop into germ cell cancer. In most cases, the exact reason these changes happen is unknown.

Main types of testicular cancer

Seminoma cancer develops from a type of germ cell and is one of the two main germ cell tumor groups. Nonseminoma tumors are the other main group and include several subtypes. Uncommon stromal tumors begin in cells that support hormone production or other testicular functions, while cancers from another part of the body can occasionally spread to the testicles.

Everyday activities, sexual activity, and a minor injury do not generally cause testicular cancer. Some medical and developmental factors can increase risk, but having one does not mean cancer will develop.

Most of these factors are not changeable, although a person’s medical history can help guide awareness and follow-up. Having a risk factor does not mean someone will develop testicular cancer, and many people diagnosed with it have no known risk factor. Discuss personal or family history with a healthcare professional.

Untreated testicular cancer can spread to nearby lymph nodes and, in more advanced cases, to organs such as the lungs, liver, or brain. Treatment is often highly effective, even when it requires more than one approach. Possible long-term concerns may come from the cancer itself or from surgery, chemotherapy, or radiation therapy.

Evaluation usually begins with a medical history and physical examination. A scrotal ultrasound can show whether a lump is inside the testicle and help distinguish it from some other causes of swelling. Blood tests may measure tumor markers, including alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-hCG), and lactate dehydrogenase (LDH).

Confirming the diagnosis

When cancer is suspected, removal of the affected testicle through an inguinal orchiectomy is commonly used to confirm the diagnosis and identify the tumor type. Doctors generally avoid putting a needle through the scrotum because this can affect cancer management. The removed tissue is examined by a pathologist.

Staging describes how far the cancer has spread. It considers the primary tumor in the testicle, whether nearby lymph nodes are involved, whether there is distant spread, and the levels of tumor markers after surgery. These findings help distinguish earlier from more advanced disease and guide treatment planning.

Testicular cancer treatment may involve one modality or a combination. The plan depends on the stage, tumor type, tumor-marker results, risk of recurrence, overall health, and response to initial therapy. Personal priorities, including fertility and quality of life, are also important.

Prognosis depends on the tumor type, stage, tumor-marker levels, spread, response to treatment, and overall health. Testicular cancer is often highly treatable, and many cases are curable even when treatment is intensive. An oncology team can explain how the individual findings affect the outlook.

Follow-up usually includes scheduled visits, physical examinations, tumor-marker testing, and imaging when indicated. The timing depends on the cancer type, stage, treatment, and risk of recurrence. Keeping these appointments helps the care team identify recurrence or late treatment effects early.